Emotional and Environmental Safety and Side Effects from Massage for Women Pregnant After a Stillbirth or Termination for Medical Reasons After 20 Weeks' Gestation

Abstract

Background: Stillbirth is the death, in utero, of a fetus from 20 weeks' gestation until immediately before birth. This may be spontaneous or can occur after termination for medical reasons (TFMR). The experience of stillbirth profoundly impacts subsequent pregnancies, with mothers frequently experiencing conflicted emotions, heightened anxiety, stress, symptoms of depression, fear, isolation, and a diminished sense of trust in a positive outcome. Supportive care options for individuals pregnant after a stillbirth or TFMR are needed to help meet their psychological and emotional needs. Individuals pregnant after a loss do not feel emotionally safe in their pregnancies; thus, the side effects and perception of safety in support interventions need to be explored. Purpose: This article reports participants' experiences of safety, the harms, and adverse events in a study exploring massage as a support for individuals pregnant after a stillbirth. Methods: The study used questionnaires to collect side effect data and qualitative interviews to examine participants' experience of safety. Results: The study found that 75% of participants experienced one or more side effects. Post-massage soreness (45.8%) was the most frequently reported side effect, followed by tiredness (43.1%). The main theme of the qualitative analysis was "safety: so much more than physical safety," reflecting the importance of safety to study participants and that safety was much more than avoiding physical harm. Conclusion: Participants needed the massage space to feel safe, both environmentally and psychologically, to facilitate their capacity to engage. Having trained massage therapists was important as this helped reassure participants that massage was a safe treatment for themselves and their baby.